Healthcare Provider Details

I. General information

NPI: 1811551757
Provider Name (Legal Business Name): BILL COMIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2019
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8019 NE 13TH AVE
VANCOUVER WA
98665-9604
US

IV. Provider business mailing address

128 GREEN ACRES WAY # B
CASTLE ROCK WA
98611-9668
US

V. Phone/Fax

Practice location:
  • Phone: 360-984-3131
  • Fax: 360-718-8542
Mailing address:
  • Phone: 360-749-1375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: